title: Efficacy of fractional microneedle radiofrequency device in the treatment of primary axillary hyperhidrosis: a pilot study.
abstract: BACKGROUND
  Fractional microneedle radiofrequency (FMR) devices deliver energy to the deep dermis through insulated microneedles without destroying the epidermis. These FMR devices have been shown to be effective for the treatment of wrinkles, acne scars and large pores. In this study it was postulated that FMR energy could specifically affect the sweat glands, preserving the skin surface even if sweat glands were seated in the deep dermis.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of FMR for primary axillary hyperhidrosis (PAH) treatment and to conduct a histological analysis before and after treatment.
  
  
  METHODS
  Twenty patients with PAH had 2 sessions of bipolar FMR treatment at 4-week intervals. Clinical improvement was evaluated using a Hyperhidrosis Disease Severity Scale (HDSS) and photographs were taken using the starch-iodine test at every visit and 2 months after the last treatment. The amount of sweat reduction was indirectly assessed using a Tewameter™. Skin biopsies were obtained from 3 of the enrolled patients before and after treatment. The satisfaction and adverse reactions of the research participants were recorded at every follow-up visit.
  
  
  RESULTS
  HDSS scores decreased significantly from a baseline of 3.3 to 1.5 and 1.8 after the first and second months of posttreatment follow-up sessions, respectively (p < 0.001). In response to a subjective assessment at 1 month after the second treatment, 75% of patients (n = 15) had an HDSS score of 1 or 2, and 70% of patients (n = 14) expressed more than 50% improvement in their sweating. The starch-iodine reaction was also remarkably reduced in 95% of patients (n = 19) after FMR treatment. Histological findings showed a decrease in the number and size of both apocrine and eccrine glands 1 month after the final treatment. Side effects were minimal and included mild discomfort, transient swelling and postinflammatory hyperpigmentation.
  
  
  CONCLUSIONS
  FMR treatment was effective for the treatment of PAH without significant adverse reactions due to direct volumetric heating of the lower dermis.
authors.affiliation: Department of Dermatology, St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
authors.forename: Miri
authors.initials: M
authors.lastname: Kim
authors.forename: Jae Yong
authors.initials: JY
authors.lastname: Shin
authors.forename: Jungsoo
authors.initials: J
authors.lastname: Lee
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Sang Ho
authors.initials: SH
authors.lastname: Oh
mesh_terms: D000328:Adult; D001050:Apocrine Glands / Q000528:radiation effects; D001365:Axilla; D004439:Eccrine Glands / Q000528:radiation effects; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000473:pathology / Q000532:radiotherapy*; D006979:Hyperthermia, Induced / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009339:Needles; D017060:Patient Satisfaction; D010865:Pilot Projects; D011846:Radio Waves / Q000009:adverse effects; D000078702:Radiofrequency Therapy; D012720:Severity of Illness Index; D014870:Water Loss, Insensible; D055815:Young Adult